MEDICARE: ARMANDO VAZQUEZ APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	APRN11017761	FL
2	363LA2200X	Adult Health Nurse Practitioner	APRN11017761	FL
3	363LG0600X	Gerontology Nurse Practitioner	APRN11017761	FL
4	363LP2300X	Primary Care Nurse Practitioner	APRN11017761	FL

General Provider Information

NPI Number	:	1972256279
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARMANDO VAZQUEZ APRN

Provider Business Mailing Address
First Line	:	5405 BEARUP ST
Second Line	:
City	:	PORT CHARLOTTE
State	:	FL
Zip	:	33981-2239
Country	:	US
Telephone Number	:	941-249-2970
Fax Number	:

Provider Business Practice Location Address
First Line	:	5405 BEARUP ST
Second Line	:
City	:	PORT CHARLOTTE
State	:	FL
Zip	:	33981-2239
Country	:	US
Telephone Number	:	941-249-2970
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/27/2022
Last Update Date	:	06/27/2024

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Directions to “ ARMANDO VAZQUEZ APRN” Practice Location

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